Tuesday, April 07, 2009

If you’ve read recent headlines, scanned online sites, listened to President Obama speak at recent news conferences, or followed the flurry of Twitter updates and Facebook status messages, then you know that health care reform is a topic reaching across all types of media.

And with good reason, given the huge economic toll rising health care costs places on us, not to mention the quality of life issues involved for people without access to care or access to appropriate care.

Obviously, health care reform is not a new topic on this blog. A few months ago I wrote about the consensus-building Summit talks sponsored by The America's Agenda Healthcare Education Fund. Today, April 7th, is the third Health Care Summit Conversation, hosted by Tommy G. Thompson, former Wisconsin governor, U.S. Secretary of Health and Human Services and Republican presidential candidate, together with the University of Wisconsin School of Law. Click here for streaming video of the event.

The point of these talks is to bring high-profile individuals from all different stakeholders involved in reform together. In a sense, the fact that individuals from across the health care spectrum (politicians, policy experts, health care providers, labor leaders, health insurance and pharmaceutical companies, etc) are engaging in these kinds of talks proves there is consensus: everyone agrees something must change, and that now is the time to do it. These conversations focus on how we can actually make that happen.

I tend to focus on the patient aspect of health care reform since it is what I live with every day, so I was interested in the opportunity to speak with Summit panelist David Y. Norton, Company Group Chairman, Worldwide Commercial and Operations of Johnson & Johnson this morning.

Given that chronic disease accounts for 75 percent of all health care costs and this is a chronic illness blog, you can probably figure out what topics I centered our conversation on. Here are some highlights:

On the best ways to reform how we approach patients with chronic disease—“There is no holistic view of the patient,” he says, pointing to our current fragmented nature of health care delivery. Whether it’s hospital care, medication, doctor appointments, etc, a more collaborative and holistic approach would not only reduce costs but increase health outcomes.

Related to this notion of holistic care is the medical home, with its emphasis on quality primary care. In addition, he feels that electronic medical records will help ensure information is shared “evenly and equally” with relevant parties.

He echoes the sentiments expressed by many right now that shifting our focus from acute treatment to incentives for wellness and prevention would make a big difference. “We currently reward treatment on fee-for-service basis, therefore the more tests you, you get paid more. But that’s necessarily quality care, so we need to focus on prevention and wellness.”

Co-pays are a disincentive for patients, particularly those with chronic diseases, since increased co-pays shift the burden of cost to them. People who don’t take their drugs see doctors more, end up in hospitals more, and end up accruing more health care costs later.

In terms of wellness initiatives and incentives, Johnson & Johnson already has a “very active program” for its employees. It includes a smoking cessation program, financial incentives for employees, healthier food options in the cafeteria, in-house fitness centers, etc. The annual savings in employee health costs is about $400. While there are other private companies doing similar things, Norton believes “we need to change the health care system to incentivize those patients in the private system and the public system to address prevention and wellness.”

On treatment of patients with rare/genetic/existing chronic disease (you knew I’d ask!)—Fundamentally, the goal is for affordable access to quality care for all citizens, and he believes pre-existing conditions should not exclude anyone from getting that quality care. More specifically, he points to stem cell research and other innovations as keys to eliminating or alleviating certain diseases.

(An aside: as a rare disease patient I would love to see even more innovative drugs come down the pipeline—can we agree we have enough nose sprays and acid reflux pills and look to sound policies that encourage the research and development of drugs that tackle smaller and rarer disease populations? Like much of this, it’s a collaborative effort.)

On the role pharmaceutical companies have in health care reform: Norton mentions that currently, pharmaceuticals account for 10 cents of every health care dollar spent. He sees improved patient education—better knowledge of their medications can lead to better compliance and less cost down the road—and physician education as important parts of reform.

As he mentioned earlier, drug innovation is another essential component, as are policies that help patients who need medication access affordable prescriptions.

* * *Any type of consensus involves different parties with different agendas, priorities, and perspectives. Getting them altogether is the first step; seeing results that accommodate everyone’s needs is much more difficult. Be sure to check out the Summit Conversations and hear what David Y. Norton, Tommy Thompson, and a diverse group of other panelists are saying about health care reform.

2 comments:

I completely agree with the holistic approach. I have several chronic health issues including lupus, Hashimoto's Thyroiditis and Hashimoto's Encephalopathy and since I started going to a naturopathic doctor, I have felt significantly better! Which has cut down on my visits to my other doctors, which has saved me AND the insurance company money. All around it has been a win/win!

I totally dig J&J, especially because of a great resource I found when writing a section of my book about young adult caregiving. J&J has a fantastic website called strengthforcaring.com that is one of the best caregiving guides I have ever seen.

A big healthcare issues is that hospitals are sending patients home so soon, leaving a lot of nursing up to the family - or in the case of many young adults - it is ourselves, or our friends and partners who are diving into the role. The J&J website really helps with excellent practical tips.